Eyeworld

57 EW CORNEA May 2018 Perry: hankcornea@gmail.com Rynerson: docjmrmd@gmail.com cleaning up these biofilms and the byproducts of disease." Clinical impacts The clinical impacts will be pro- found when physicians understand they can prevent lid margin disease with regular professional cleaning of the lids, every 4–6 months, Dr. Rynerson said. "Our first step is to provide understanding that existing dry eye can be definitively treated, provid- ing tremendous relief to patients," Dr. Rynerson said. "Once that is well known, prevention will be the logi- cal next step. We all have lid margin biofilms. The key will be to keep it in check and not allow it to become inflammatory." For Dr. Hovanesian, the biggest clinical implication is the need to treat dry eye symptoms on eyelids or lashes at an early stage because "we know that increasingly symp- tomatic dry eye causes multiple issues." "We often try to ignore the de- bris on their lids and we shouldn't do that; we should try to treat it," Dr. Hovanesian said. "There are a number of ways to do this and a number of topical solutions that patients should use." Dr. Hovanesian has seen drastic turnarounds in patients who have had recalcitrant dry eye that he has handled through the removal of biofilm, and they've had symptom- atic improvement. The most important clinical im- plication of the theory to Dr. Perry is the need it underscores for patient education. "In certain countries where they have a lower degree of dry eye and eye problems than we do, they begin instructing the children in lid hygiene in kindergarten," Dr. Perry said. "They do warm saltwater soaks early and have fewer eye problems. It's like brushing your teeth but for your eyelids. Keep your eyelid mar- gins clean." EW References 1. Rynerson JM, et al. DEBS—A unification theory for dry eye and blepharitis. Clin Oph- thalmol. 2016;10:2455–2467. 2. Craig JP, et al. TFOS DEWS II Report Execu- tive Summary. Ocul Surf. 2017;15:802–812. Editors' note: Dr. Rynerson and Dr. Hovanesian have financial interests with BlephEx. Dr. Perry has financial interests with NovaBay Pharmaceu- ticals (Emeryville, California) and BlephEx. Contact information Hovanesian: jhovanesian@harvardeye.com NEW Tr u e D r y E y e S o l u t i o n s SILICONE PUNCTUM PLUG with pen inserter SOFT PLUG ® SOFT PLUG ® Extended Duration180 Medium -term Lasts up to 180 days Oasis LID & LASH ® Eyelid & Lash Cleansing Pads Oasis TEARS PF ® Preservative Free Original with Tea Tree Oil Gratitude. A natural response to relief. NEW: OASISMEDICAL.COM REGISTER TODAY Call to order: 844-820-8940 Oasis TEARS, Oasis LID & LASH, SOFT PLUG, & OASIS names & logos are registered trademarks of OASIS Medical, Inc. 514 S. Vermont Ave, Glendora, CA 91741. LIT-EyeWorld-Island Rev0 03/2018 Request a catalog from: customerservice@oasismedical.com

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